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首页> 外文期刊>Journal of orthopaedic research >Cement interface and bone stress in total hip arthroplasty: Relationship to head size
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Cement interface and bone stress in total hip arthroplasty: Relationship to head size

机译：总髋关节置换术中的水泥界面和骨胁迫：头部尺寸的关系

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The use of larger prosthetic femoral heads in total hip arthroplasty (THA) has increased considerably in recent years in response to the need to improve joint stability and reduce risk of dislocation. However, data suggests larger femoral heads are associated with higher joint failure rates. For cemented implants, ensuring the continued integrity of the cement mantle is key to long term fixation. This paper describes an investigation into the effect of variation in femoral head size on stresses in the acetabular cement mantle and pelvic bone. Three commonly used femoral head sizes: 28, 32, and 36 mm diameter were investigated. The study was undertaken using a finite element model validated using surface strains obtained from Digital Image Correlation (DIC) during experimentation on a composite hemipelvis implanted with a cemented all-polyethylene acetabular cup. Following validation, the models were used to investigate stresses in the pelvic bone and acetabular cement mantle resulting from two loading scenarios; an average weight subject (700 N) and an overweight subject (1,000 N) undertaking a single leg stand. We found that the highest peak stresses occurred in the anterosuperior and posterosuperior regions of the bone-cement interface, in the line of action of the load, where debonding usually initiates. Stress on the cortical bone-cement interface increased with femoral head diameter by up to 9% whilst stresses in the trabecular bone remained relatively invariant. Our findings may help to explain higher joint failure rates associated with larger femoral heads. (c) 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2966-2977, 2018.
机译：近年来，在总髋关节关节置换术（THA）中使用较大的假体股头，近年来，响应需要提高关节稳定性并降低脱位风险的需要增加了大大增加。然而，数据表明较大的股骨头与更高的关节失效率相关联。对于粘合的植入物，确保水泥地幔的持续完整性是长期固定的关键。本文介绍了对股骨头尺寸变化对髋臼壳体和盆腔骨胁迫的影响的研究。研究了三种常用的股骨头尺寸：28,32和36 mm直径。使用使用从数字图像相关（DIC）获得的有限元模型进行的有限元模型进行了研究，在植入用胶合的全聚乙烯髋臼杯的复合血链上的实验期间验证。在验证之后，模型用于研究由两种加载方案产生的盆腔骨和髋臼水泥地幔中的应力;平均重量主题（700 n）和一个腿部支架进行的超重主题（1,000n）。我们发现，在骨水泥界面的Anterosuiorior和后孔区域发生的最高峰值应力，在负载的作用中，剥离通常引起。皮质骨水泥界面上的应力随股骨头直径增加，在小梁骨中的应力仍然相对不变。我们的调查结果可能有助于解释与较大的股骨头相关的更高的关节失败率。 （c）2018年骨科研究会。由Wiley期刊出版，Inc.J Orthop Res 36：2966-2977,2018。

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